thomson court care home service adults

Thomson CourtCare Home Service AdultsTownheadRothesayPA20 9JHTelephone: 01700 503166

Inspected by: Elspeth Gibb

Type of inspection: Unannounced

Inspection completed on: 20 March 2012

ContentsPage No

Summary 31 About the service we inspected 52 How we inspected this service 73 The inspection 104 Other information 175 Summary of grades 186 Inspection and grading history 18

Service provided by:Argyll and Bute Council

Service provider number:SP2003003373

Care service number:CS2003000453

Contact details for the inspector who inspected this service:Elspeth GibbTelephone 0141 843 6840Email [email protected]

Inspection report continued

Thomson Court, page 2 of 20

SummaryThis report and grades represent our assessment of the quality of the areas ofperformance which were examined during this inspection.

Grades for this care service may change after this inspection following otherregulatory activity. For example, if we have to take enforcement action to make theservice improve, or if we investigate and agree with a complaint someone makesabout the service.

We gave the service these grades

Quality of Care and Support 5 Very Good

Quality of Environment N/A

Quality of Staffing N/A

Quality of Management and Leadership 5 Very Good

What the service does wellThomson Court provides a good service for older people in Bute which is greatlyvalued by the local community.

The staff team work well together to create a good homely environment for people tolive in.

There was strong evidence that the service responds well to any issues raised by thepeople using the service and their families.

Staff are adapting well to the changing needs of the people using the service.

What the service could do betterStaff will require ongoing support to manage the complex support needs of serviceusers. Careful attention is needed to ensure that staffing levels are appropriate to thecomplex needs of some people using the service.There have been some recent changes to the staff team and the manager is workinghard to maintain stable and positive staffing arrangements.

What the service has done since the last inspectionThis was a very short inspection and no new quality statements were looked at. Therehas been some staffing difficulties which have caused some disruption to the service.



ConclusionThe service is currently adapting to recent changes. The manager is responsive to theimprovements suggested by the Care Inspectorate.

Who did this inspectionElspeth GibbLay assessor: Not Applicable.



1 About the service we inspectedSocial Care and Social Work Improvement Scotland (SCSWIS) is the new regulatorybody for care services in Scotland. It will award grades for services based on thefindings of inspections. The history of grades that services have previously beenawarded by the Care Commission will also be available on the SCSWIS website. Thisservice was deemed registered with SCSWIS on 1 April 2011.

All references in this report will be to The Social Care and Social Work ImprovementScotland (Requirements for Care Services) Regulations 2011 ("the Regulations") (SSI2011/210).

Providers were also reminded that they had to make use of the SCSWIS 'guidance onnotification reporting for all registered services' and the document outlining 'Recordsregistered care services must keep' both of which can be found on the SCSWISwebsite.

Thomson Court is owned and managed by Argyll and Bute Council CommunityServices and it is situated on the outskirts of Rothesay. The service has beenregistered with the Care Commission since 1 April 2002, and is registered to providecare to a maximum of 8 residents.

All residents have single rooms with en-suite facilities, the accommodation is of ahigh standard and provides a warm, comfortable, homely environment for theresidents.

Thomson Court's philosophy aims "to provide residents/clients with a relaxed,amiable environment where staff are highly motivated and constantly endeavouringto ensure the highest possible quality of care while working to meet Argyll and Bute'spolicies and procedures and the National Care Standards set by the ScottishExecutive".

Based on the findings of this inspection this service has been awarded the followinggrades:

Quality of Care and Support - Grade 5 - Very GoodQuality of Environment - N/AQuality of Staffing - N/AQuality of Management and Leadership - Grade 5 - Very Good

This report and grades represent our assessment of the quality of the areas ofperformance which were examined during this inspection.



Grades for this care service may change following other regulatory activity. You canfind the most up-to-date grades for this service by visiting our websitewww.scswis.com or by calling us on 0845 600 9527 or visiting one of our offices.



2 How we inspected this service

The level of inspection we carried outIn this service we carried out a low intensity inspection. We carry out theseinspections when we are satisfied that services are working hard to provideconsistently high standards of care.

What we did during the inspectionWe wrote this report following an announced inspection that took place on 20thMarch 2012. The inspection was carried out by Elspeth Gibb.

The report is a summary of the findings and detailed feedback was given to the actingmanager at the end of the inspection.

As requested by us, the care service sent us an annual return. The service also sent aself assessment form.

During this inspection we gathered evidence from relevant sections of policies,procedures, records and other documentation including:

Personal plans and associated recordsHealth recordsStaff training recordsStaff meeting minutesQuestionnairesRegistration certificateAccident and incident records.

We also had discussions with the people who use the service and spoke with theacting manager and the staff team.

Grading the service against quality themes and statementsWe inspect and grade elements of care that we call 'quality themes'. For example,one of the quality themes we might look at is 'Quality of care and support'. Undereach quality theme are 'quality statements' which describe what a service should bedoing well for that theme. We grade how the service performs against the qualitythemes and statements.

Details of what we found are in Section 3: The inspection



Inspection Focus Areas (IFAs)In any year we may decide on specific aspects of care to focus on during ourinspections. These are extra checks we make on top of all the normal ones we makeduring inspection. We do this to gather information about the quality of these aspectsof care on a national basis. Where we have examined an inspection focus area we willclearly identify it under the relevant quality statement.

Fire safety issuesWe do not regulate fire safety. Local fire and rescue services are responsible forchecking services. However, where significant fire safety issues become apparent, wewill alert the relevant fire and rescue services so they may consider what action totake. You can find out more about care services' responsibilities for fire safety atwww.firelawscotland.org



What the service has done to meet any recommendations we madeat our last inspectionThe previous inspection highlighted the need for further training in end of life andpalliative care. This has been achieved.

The annual returnEvery year all care services must complete an 'annual return' form to make sure theinformation we hold is up to date. We also use annual returns to decide how we willinspect the service.Annual Return Received: Yes - Electronic

Comments on Self AssessmentEvery year all care services must complete a 'self assessment' form telling us howtheir service is performing. We check to make sure this assessment is accurate.This inspection related to the self assessment which was completed prior to the lastinspection .

Taking the views of people using the care service into accountThe people who were able to comment were very positive about the quality of staffand the level of care they receive.Comments included:

"I am contented here and staff look after me very well""I like this room - it is home from home"

Taking carers' views into accountNo family members were involved in this very short inspection.



3 The inspectionWe looked at how the service performs against the following quality themes andstatements. Here are the details of what we found.

Quality Theme 1: Quality of Care and SupportGrade awarded for this theme: 5 - Very Good

Statement 1We ensure that service users and carers participate in assessing and improving thequality of the care and support provided by the service.

Service strengthsWe found that this service was performing very well in the areas covered by thisstatement.

There are many systems in place to help people be involved in the service andpromote participation in the way the service runs. There was strong evidence of staffinvolving the people who use the service and their relatives in decisions about theirown care.

Relatives are encouraged to be part of daily life in Thomson Court and each personhas a key worker whom they can approach at any time.

Support plans indicate that personal preferences are known and individualpreferences and lifestyle choices are noted in each person's plan.

Relatives, the people who use the service and some staff were involved in the gradingof the service in the last self assessment.

The provider asks for people's views in an annual questionnaire and there is a carers'support group which offers the opportunity to input to the service.

Areas for improvementStaff should continue to promote participation at each person's review meeting inways which make a difference to them. As discussed at the previous inspection, beingclear about what people want and deciding who will be responsible for taking actionwill help to improve the service. The new review format supports consistentinvolvement in all aspects of the individual's care.



Staff would benefit from ongoing training in communicating effectively with thoseindividuals who have difficulty communicating verbally.

Grade awarded for this statement: 5 - Very Good

Number of requirements: 0

Number of recommendations: 0

Statement 3We ensure that service user's health and wellbeing needs are met.

Service strengthsWe found that this service was performing very well in the areas covered by thisstatement. We concluded this after looking at personal plans and speaking with staff,and the people who use the service.

Staff ensure that regular contact is made with health related practitioners such aschiropodists, opticians and audiology specialists when they require support.

A nutritional policy is in place and referrals are made to the dietitian as required. Foodpreferences as noted in care plans and people have access to a varied menu fromwhich they can make choices.

Each person's personal plan includes an assessment of their health needs and recordsall contact with health professionals. Records showed that health concerns are beingraised quickly and efficiently. Risk assessments for nutrition and pressure care are inplace and personal plans indicated that in general health issues were being managedwell. Staff know how to support specific needs such as supporting people who havedifficulty swallowing their food and those who need special diets.

Staff have had extensive training to meet the individual needs of those who requireintensive support and discussion with them showed that they were keen to learn bestpractice and felt well supported by health care professionals.

Staff have received training in palliative and end of life care since the last inspection.



Areas for improvementManagement staff will require to monitor carefully the effectiveness of health care inthe service as staff are now required to support very complex health needs. Ongoingtraining and support will be required on an ongoing basis.

Grade awarded for this statement: 5 - Very GoodNumber of requirements: 0Number of recommendations: 0



Quality Theme 2: Quality of Environment - NOT ASSESSED



Quality Theme 3: Quality of Staffing - NOT ASSESSED



Quality Theme 4: Quality of Management and LeadershipGrade awarded for this theme: 5 - Very Good

Statement 1We ensure that service users and carers participate in assessing and improving thequality of the management and leadership of the service.

Service strengthsThe manager, staff and the people using the service confirmed that there is an openand responsive approach to the management of the service and there is an open doorpolicy.

There was evidence that regular reviews with service users and their relatives takeplace and that information from reviews inform staff actions.Detailed information about how the service promotes participation is included.

Areas for improvementThe service self assessment highlights the need to keep promoting the participationstrategy and encourage service users and staff to use the group and individualconsultation meetings which have been set up.


Statement 4We use quality assurance systems and processes which involve service users, carers,staff and stakeholders to assess the quality of service we provide.

Service strengthsThomson Court is a small service which benefits from daily individual contact witheach person by the manager and senior staff. Staff enjoy very positive relationshipswith family members and the feedback from families is consistently very positive.

There is a communication book in each person's room for family members to writecomments or suggestions.

There is a comprehensive schedule of senior staff and care staff meetings all of whichenable the manager to ensure that a high quality service is maintained.

All staff have regular one to one supervision and an annual staff appraisal.



The provider sends out questionnaires to seek the views and suggestions of all thoseusing the service.

Areas for improvementThe implementation of the new review format , which seeks feedback across all thequality themes will, over time, impact on the accountability of the service and be avaluable part of the quality assurance system in the service. This will be explored atthe next inspection of the service.




4 Other information

ComplaintsNo complaints have been upheld, or partially upheld, since the last inspection.

EnforcementsWe have taken no enforcement action against this care service since the lastinspection.

Additional InformationAt the time of writing this report the Care Inspectorate has upheld a complaintagainst the service. The outcome of the complaint was not known at the time of theinspection.The issues raised by the complaint will be explored at the next inspection of theservice.

Action PlanFailure to submit an appropriate action plan within the required timescale, includingany agreed extension, where requirements and recommendations have been made,will result in SCSWIS re-grading the Quality Statement within the Management andLeadership Theme as unsatisfactory (1). This will result in the Quality Theme forManagement and Leadership being re-graded as Unsatisfactory (1).



5 Summary of grades

Quality of Care and Support - 5 - Very Good

Statement 1 5 - Very Good


Quality of Environment - Not Assessed

Quality of Staffing - Not Assessed

Quality of Management and Leadership - 5 - Very Good



6 Inspection and grading history

Date Type Gradings

17 May 2011 Unannounced Care and support 5 - Very GoodEnvironment Not AssessedStaffing Not AssessedManagement and Leadership 5 - Very Good

10 Jan 2011 Unannounced Care and support 4 - GoodEnvironment Not AssessedStaffing Not AssessedManagement and Leadership Not Assessed

19 Aug 2010 Announced Care and support 4 - GoodEnvironment Not AssessedStaffing 4 - GoodManagement and Leadership Not Assessed

18 Feb 2010 Unannounced Care and support 5 - Very GoodEnvironment 4 - GoodStaffing 4 - GoodManagement and Leadership 4 - Good



21 Aug 2009 Announced Care and support 4 - GoodEnvironment 4 - GoodStaffing 4 - GoodManagement and Leadership 4 - Good

17 Mar 2009 Unannounced Care and support 4 - GoodEnvironment 4 - GoodStaffing 4 - GoodManagement and Leadership 4 - Good

15 May 2008 Announced Care and support 3 - AdequateEnvironment 3 - AdequateStaffing 3 - AdequateManagement and Leadership 3 - Adequate

All inspections and grades before 1 April 2011 are those reported by the formerregulator of care services, the Care Commission.



To find out more about our inspections and inspection reportsRead our leaflet 'How we inspect'. You can download it from our website or ask us tosend you a copy by telephoning us on 0845 600 9527.

This inspection report is published by SCSWIS. You can get more copies of this reportand others by downloading it from our website:www.scswis.com or by telephoning 0845 600 9527.

Translations and alternative formatsThis inspection report is available in other languages and formats on request.

Telephone: 0845 600 9527Email: [email protected]: www.scswis.com



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